The proposed Center of Excellence (P30) will promote biobehavioral research to extend symptom science using the Adaptive Leadership (AL) framework to conceptualize and study cognitive/affective symptoms in chronic illness. The overall Center aims are to: (1) Enhance and sustain the productivity of new nursing scientists engaged in interdisciplinary biobehavioral research to understand and ameliorate symptoms, symptom distress, and symptom sequelae using adaptive approaches for people with cognitive/affective changes in chronic illness; (2) Assist investigators to tailor research approaches and interventions to optimize research participation by people with cognitive/affective changes by addressing minority health issues and refining existing, or creating new intervention protocols and self-report measures (i.e., Patient-Reported Outcomes Measurement Information System [PROMIS]. (3) Increase investigator competence in using longitudinal quantitative, qualitative, and mixed method approaches to examine the trajectories of symptoms, symptom sequelae and patient adaptation associated with cognitive/affective changes. The work of the Center will be carried by in three Cores, the Administrative Core, the Mentoring and Scholarship Core, and the Design and Methods Core. Expected outcomes of the center include studies of trajectories of cognitive/affective symptoms and symptom sequelae to describe patterns, variability, and change over time to gain knowledge needed about critical periods or transition points for timing of interventions, identify differences within subpopulatios such as those with varying levels of cognitive ability or minority health needs, and generate knowledge for developing/testing interventions to enhance patients' adaptive capabilities. PUBLIC HEALTH RELEVANCE: Barriers to care arise for people with cognitive/affective changes because they may not clearly convey concerns or communicate easily. If not addressed through research, these barriers will create health disparities. Center researchers will study trajectories of cognitive/affective symptoms and symptom sequelae to gain knowledge needed for developing tailored interventions and enhance care for these populations.